Don’t Fear Hunger
“I make sure I have my protein drink in the morning, so I don’t get hungry at work.”
We hear patients in clinic say this all the time, and while it’s not a crazy idea, it turns out to be counter-productive for lifetime weight control.
Here’s the key message: adults do not need to eat regularly scheduled meals or to eat three meals per day. Kids may benefit from eating frequently, but adults tend to be healthier and to have better-controlled hunger if they eat only twice per day. This style of eating less often is called “Intermittent Fasting,” or “Intentional Fasting.” It turns out that eating frequently “to keep the motor running” actually leads to increased insulin resistance and then to increased hunger. Almost paradoxically, eating less frequently tends to lead to less hunger, and hunger signals that are easier to live with.
Please don’t worry: our team is not suggesting that you walk around feeling like you’re starving all the time. Instead, we’re suggesting for you to notice if you feel hungry or not when “mealtime” rolls around. If you’re not hungry, that’s awesome, and we suggest you do not need to eat if you’re not hungry. If people just choose not to eat when they don’t feel hungry, most will settle down to a pattern of eating about twice per day. Intermittent Fasting like this usually leads to less calorie intake and less hunger and a healthy metabolism. Patients maintain a lower weight, excellent nutrition, and they feel well.
Many patients want to try this plan of Intermittent Fasting, but they worry they will be at work and will be ambushed by hunger at a time when they can’t take care of the hunger. Concerned about this prospect, they eat “pre-emptively” before they head off to work. Even though this is a logical habit, my experience is that it’s not necessary to feel well and to function at a high level. Eating to “prevent” or “preempt” hunger doesn’t help your metabolism; it’s just some calories that you didn’t need. Let’s explore further!
It seems important to understand that those who have had the obesity disease, before bariatric surgery, had hunger hormone imbalances that led to “crazy” hunger, aggressive hunger, HANGRINESS. Most of them had episodes of hunger that occurred frequently, and when hunger came it was overwhelming, intrusive, distracting. Even if the hunger did not make sense from a health/physiology perspective, the sensations were real and they were actually disruptive to thought processes, emotions, and the business of the day. If that’s the type of hunger you have, it makes sense to do whatever you need to do, to keep it away!
Intermittent Fasting to Maintain Metabolic Balance After Bariatric Surgery
Hopefully (and realistically) it’s a different ballgame after your bariatric operation. After surgery, as long as you’re in a healthy metabolic balance, we can expect that you’ll have a smaller and a more sensible hunger. This would be a hunger that causes you to anticipate food and appreciate food to increase enjoyment, but should not interfere with your emotions or your thought processes. This should be a hunger that you can comfortably live alongside for several hours if it’s not convenient to eat. For most people in a healthy metabolic balance, hunger is more like a friendly signal that your body is ready for some nutrition. And if hunger is not behaving that way for you now, we should be able to work together to train your hunger in a more “tame” and supportive direction.
So, give it a try! See how it feels to be hungry for a little while! We hope you’ll find it’s not painful and it doesn’t drive you crazy. Also, take a look at our practice website and search for Dr. Anz’s excellent blog about intermittent or intentional fasting.
If you find that your hunger does drive you crazy, you might be experiencing what we call “cravings,” which is an aggressive hunger that usually indicates your metabolism is out of balance. Especially if this happens at 6 months or more after your bariatric surgery, there’s a good chance there is something going on that we can improve, so we highly recommend for you to visit back with the bariatric team to get back on track.